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The Link Between Constipation and Pelvic Organ Prolapse

The Link Between Constipation and Pelvic Organ Prolapse

It’s rare to find someone who hasn’t encountered a little constipation now and then. Chronic problems with constipation, however, often signal a larger problem and, for women, that might be pelvic organ prolapse (POP). This is a condition that affects one in five women in the United States. Depending upon which organs are affected by POP, constipation can develop.

To shed some light on the connection between pelvic organ prolapse and constipation, Dr. Fernando Otero and the team here at Women’s Clinic of the Rio Grande Valley pulled together the following information.

Pelvic organ prolapse basics

The organs in your pelvis are supported by your pelvic floor, which is a group of muscles that acts as a sort of hammock. If this floor weakens, organs can shift downward, causing a wide range of symptoms depending upon the degree of the prolapse and which organs are involved.

Women are far more prone to POP, especially after they pass through menopause. The loss of reproductive hormones weakens the supportive tissues, allowing organs to shift out of place.

There are five different types of POP, including:

  1. Bladder prolapse — your bladder shifts down into your vaginal canal
  2. Uterine prolapse — your uterus drops down into your vaginal canal
  3. Enterocele — your small intestine bulges into your vagina
  4. Vaginal vault — the top of your vagina collapses into your vaginal canal
  5. Rectal prolapse — the tissue dividing your vagina and rectum weakens, causing the top of your rectum to collapse down toward your anus

For the purposes of this discussion, we’re going to focus on the last type of prolapse, which is also called rectocele, as this form of prolapse most often leads to constipation.

Rectal prolapse

Of all the types of POP, rectal prolapse isn’t all that common, affecting about 2.5 people out of 100,000. Of this small number, women make up most of the cases, as women over the age of 50 are six times more likely to develop rectal prolapse than men.

The symptoms of rectal prolapse are often gradual. At first, your rectum may prolapse only with a bowel movement before returning to its normal position. As it progresses, the tissue may stay outside your anus and you have to push it back inside. 

As you can imagine, this loose tissue can interfere with your bowel movements, leading to constipation, a symptom reported by up to 50% or more people with rectal prolapse.

Making matters worse, if your rectum becomes fully prolapsed, it can weaken the anal sphincter and lead to fecal incontinence, which affects between 50% and 75% of people with rectocele.

Interestingly, the link between constipation and rectal prolapse is a two-way street — if you’ve had chronic issues with constipation, you may be more vulnerable to rectocele.

Treating rectal prolapse

If your rectal prolapse is in the early stages, doing pelvic floor exercises and taking medications that help stool to pass more easily may help.

In the later stages of rectal prolapse, minimally invasive surgery may be necessary to restore the support of your rectum.

If you’d like to determine whether your constipation might be linked to pelvic organ prolapse, please contact one of our offices in McAllen or Edinburg, Texas, to schedule an appointment.

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